Holly Grigg-Spall is a young woman who calls herself a feminist but who is deeply unpopular with some of the sisterhood right now. English, 30-ish, married to an American and living in California, she has written a book criticising the contraceptive pill. Actually, Sweetening the Pill: Or How We Got Hooked On Hormonal Birth Control is more than critical; it is a sweeping polemic against the pill and every form of hormonal contraception. Since this wonder drug is celebrated by mainstream feminists (Nancy Pelosi, Cecile Richards, Sandra Fluke…) as the great liberator of women, you can see why the others are peeved with her.

And yet, Ms Grigg-Spall (pictured, right) has so much in common with the pill’s diehard champions. Like Ms Fluke, she grew to adulthood thinking that taking this medicine daily was as natural as having toast for breakfast. Like Ms Pelosi and Ms Richards, she thinks contraception is a reproductive right. (No, she is not from what she calls “the religious Right”.) But, although once “hooked” on them, she has fallen out of love with synthetic hormones and wants everyone to know why.

In her mid-20s, when she should have been feeling on top of the world, Holly Grigg-Spall was feeling depressed and empty, ho-hum about sex. And that was when she was not feeling anxious and paranoid or erupting into furious arguments with her boyfriend. “I felt I was losing my mind,” she says.

She had been on the pill since she was 17, when her mother and family doctor told her it would solve the problem of heavy and painful periods as well as protect her against pregnancy. She did not yet have a boyfriend and would not become sexually active for another four years, but she accepted their view that it was the responsible thing to do. She knew nothing about how the pill worked – other than stopping babies arriving – and did not think to ask.

Ten years later, in 2008, she was still largely ignorant about what was going on in her body. She had been dutifully swallowing the pill in various forms and was currently on Yasmin (or Yaz), at her own request, having been impressed by Bayer’s aggressive advertising campaign for this “lifestyle” drug that cleared up acne and prevented side effects such as the weight gain often associated with the pill. A conversation with a friend, however, made her suspect it was this drug that was causing her mood swings and ruining her life.

She started to read health feminist literature and ask questions. Gradually overcoming her fear – no, terror -- of becoming pregnant, she abandoned the pill altogether and relied on non-hormonal methods of contraception. Reports of women on Yasmin experiencing and even dying from blood clots, Federal Drug Administration action against Bayer in 2009 and mounting lawsuits against the company for its failure to inform users properly about its risks provided the impetus to turn Grigg-Spall into a crusader. By then she had moved with her husband to the US where she launched a blog about her experience, attracting stories from other pill refugees.

In May 2010 when the 50th anniversary of the pill’s launching was being celebrated by economists, health professionals, population controllers and feminists alike, she gained a sympathetic hearing from some of the mainstream media with a piece in the UK Independent, an interview on BBC radio and respectful mentions in the London Times and the Washington Post. She has guest blogged on the feminist sites Ms Magazine and (ahem) Bitch.

With the publication of her book, however, that attention has changed to annoyance and disdain. “Sweetening the Pill offers an insultingly reductive account of what it means to be female,” fumes Slate writer Lyndsay Beyerstein in a review that goes to some lengths to rebut the author’s claims. Bitch has another lengthy critique of Grigg-Spall’s treatment of “the science” under the heading “…a Completely Frustrating New Book on Birth Control”.

I found the book rather frustrating, too, but not for the same reasons. The review copy I received is repetitive and needs a lot more editing. In addition, the author’s quest for alternatives to the pill – both technical and philosophical – leads her into feminist fringe territory which is sometimes cringe-inducing. And she fails to see the logical consequences of some of her insights. Nevertheless, in her attempt at a comprehensive critique of the pill and allied contraceptives she gets some important things right.

The contraceptive pill is designed to treat no illness, but it can make healthy women sick.

In The Doctor’s Case Against the Pill (1969), trail-blazing health feminist Barbara Seaman quotes a James Balog of Merck Pharmceuticals: “The issue was whether any woman would take a pill every day to prevent the chance she might get pregnant. They believed no one’s going to do that, not when they’re not even sick, and they’re not even sick!” This is one of many telling quotations in Sweetening the Pill.

Female fertility is not an illness. The monthly cycle indicates that the body is healthy and functioning as designed. At the age of 27 Grigg-Spall was stunned to realise that the pill did not “regulate” her periods – it replaced them with “fake” periods. And the synthetic hormones which stopped her ovulating affected her whole body – not only the endocrine system but also the immune and neurological systems. Here was an explanation for her regular urinary tract infections, sore and bleeding gums, low blood sugar, hair loss and muscle weakness – on top of her mood disorders and mental fog.

And those are only the milder effects the pill can have. It doubles the risk of a blood clot. In the case of Yasmin/Yaz the risk is another 50 to 75 percent higher and is cited in heart attacks, strokes and gallbladder disease as well. The pill is also implicated in heart disease, breast and cervical cancer; women who start using hormonal contraception young are particularly vulnerable to these effects.

Yet health authorities and agencies such as Planned Parenthood are going all out to get teenagers onto long acting hormonal methods (LARCs) including the injection, the implant and the hormone releasing IUD, since young women have shown themselves unreliable in taking the pill. The National Campaign to Prevent Teen and Unplanned Pregnancy website has promoted long acting methods with the line, “We love our LARCs because they let us get lucky without leaving anything to chance.” Get lucky? The cynicism behind this is breathtaking.

Defenders of contraceptive drugs dismiss the risk of blood clots, for example, as reasonable compared with those of pregnancy, and cite benign effects on a range of conditions from acne to endometriosis. But pregnancy and childbirth – and the natural menstrual cycle itself, Grigg-Spall strongly argues -- are protective of women’s health in a number of ways, and the fact that the pill happens to be useful in correcting some disorders hardly justifies drugging hundreds of millions of women around the world who do not have those conditions.

The pill is misogynistic, arising from fear of female fertility

Following other feminist critics of the pill, she sees its development as the work of a male dominated capitalist system which has long been impatient with the female body and psyche. This ignores the socialist-welfare contribution to pill “addiction” which is at least as influential. Moreover, the extremes of both systems spring from materialism and a proprietary attitude to nature.

But you need not accept the details of Grigg-Spall’s analysis to agree with her general thesis. It is no accident that The Economist once named the pill one of the seven wonders of the modern world. It clearly suited twentieth century capitalism to have women in the workforce earning the wherewithal to boost consumption, rather than at home raising children – and to have socialists providing an added rationale.

The fear, of course, was largely on account of poor and lowly women both at home and in the developing world who threatened peace and prosperity with their “excessive” childbearing – an attitude which still drives the global commitment to birth control. Grigg-Spall has perceptive commentary on population control and the risks its chief agents are willing to take with the health of the world’s poor – including the drive to get women onto the contraceptive injection even though there is evidence that it is facilitating the spread of HIV/AIDS. The WHO and Bill and Melinda Gates get a special mention here.

None of this would have happened, however, unless women themselves had bought into contempt for their fertility. Feminists embraced the pill because it gave women “control” of their own bodies within a sexual relationship. Ironically, says Grigg-Spall, they have handed this control to a misogynistic medical fraternity who dole out pills like candy, withholding the full story about what it does to the body.

In agreeing to this radical manipulation of female bodies for the sake of sex without consequences feminists end up endorsing the male mode of being as the ideal one. Women can now have sex “like a man”, though Grigg-Spall questions the male stereotype implied here. From this comes “sex positive feminism” with its liberal ideology and embrace of pornography, and radical gender politics dedicated to “smashing the binary” system of male and female. If being female is a disease, here is the ultimate answer.

Grigg-Spall’s answer to this whole trend is for women to get to know their bodies, reclaim the natural menstrual cycle and insist on living and working according to its rhythms – something she believes will benefit both women and the marketplace. There’s a lot about this in her book, ranging over a wide field – from “Catholic” natural family planning to menstrual activists who track their cycles by the moon – and some of it is rather far-fetched (taking days of work during your period, doing different types of tasks at different times of the month…) but the basic idea of the marketplace adapting itself more to women is no more than many mainstream feminists are also advocating, and is sound.

“We are addicted to the pill”

Does she really mean that the pill is an addictive drug? The Slate critic thinks so – and that the idea is ridiculous. But there are ways in which it rings true. The pill – and even more, LARCs – are the fast-food version of contraception, advertised as “safe, easy, reliable”. Above all easy, because, you know, women… you can’t expect much of them… Take and forget. Get an implant and never think about birth control for another three to five years. This kind of sales talk, which minimises responsibility, also creates dependency, and, after Sandra Fluke and the Obamacare-contraceptive mandate debate, who can doubt that women are utterly dependent on contraception? Some 80 percent of women in the US born after 1945 have used the pill.

The medical and pharmaceutical industries certainly act like drug pushers, says Grigg-Spall. “For every dollar spent on basic research, $19 goes to advertising and marketing,” she writes of Big Pharma. More and more the “hook” for the latest pill is about its lifestyle benefits: better hair, clearer skin, no weight gain – things no young woman can do without. The media, from women’s magazines to national television networks, do well out of this advertising, which helps to explain their uncritical attitude to the pill. Doctors also are susceptible to drug company pitches and incentives.

Then, having done their damage to women’s health -- Grigg-Spall lays the blame for that fact that some 30 percent of women in the US have some type of vaginosis, or vaginal infection, at the door of the pill and its assault on body chemistry -- these sectors cash in on the remedies. One could add as another beneficiary of this chemical roulette the fertility industry, which has thrived on the infertility caused by delayed childbearing and the diseases contracted during a decade or two of sexual relationships supposedly “protected” by the pill.

Then there’s the whole wide area of the commodification of female sexuality, whereby the inwardly de-sexed, hormonally neutered woman is “sold back” her femaleness piece by piece in the form of must-have products to make her outwardly “sexy” – an idea Grigg-Spall picks up from another feminist author.

Body literacy and natural family planning

Sweetening the Pill falls far short of the critique of contraceptive culture some of us would like to hear from a smart and angry young woman. The author does not see that the copper IUD, the condom and the rest of contraceptive paraphernalia – not to mention abortion – are also an insult to the body, if not to its chemistry then at least to its integrity in the sexual act. Breaking away from the medical establishment’s grip is hardly a liberation if you fall straight into the arms of condom and cap manufacturers.

However, Holly Grigg-Spall’s great discovery – the ability to track her menstrual cycle through the fertility awareness method (FAM, or NFP to those who know it as natural family planning) – may yet lead her to new philosophical insights as well. She has already picked up on the way this method can improve the relationship between spouses or partners. For the moment she is anxious to dissociate herself from the philosophy of “the religious Right” and seems to think it is a shame that Catholics perfected the method before feminists tumbled to it.

But, if her book did nothing else than encourage other young women to pursue body literacy and fertility awareness, it would have performed a signal service.

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